Effects of intranasal mometasone furoate on blood pressure in patients with allergic rhinitis.

BACKGROUND: Nasal congestion as the main symptom in patients with allergic rhinitis can impair nasal breathing. It causes hypoxia and concomitant sympathetic system activation, which may also lead to increased blood pressure levels in these patients. OBJECTIVE: We postulated that appropriate therapy, including intranasal steroids, decreases blood pressure levels in patients with allergic rhinitis. METHODS: In our study, we investigated the effect of intranasal steroid (4 weeks of mometasone furoate) on blood pressure changes in 45 patients with allergic rhinitis whose main complaint was nasal congestion. We used ambulatory monitoring for determining blood pressure levels before and after intranasal steroid therapy. None of the patients had any other systemic diseases. RESULTS: We found a significant decrease of daytime systolic and diastolic blood pressures and mean blood pressure values (daytime systolic blood pressure: 120 vs. 117 mmHg, p = 0.024; daytime diastolic blood pressure: 73 vs. 71 mmHg, p = 0.027; daytime mean blood pressure: 86 vs. 83 mmHg, p = 0.007). Although insignificant, we also found lower night-time systolic and mean blood pressure values (nighttime systolic blood pressure: 109 vs. 107 mmHg, p = 0.182; nighttime mean blood pressure 77 vs. 73 mmHg, p = 0.116). CONCLUSIONS: We found that post-treatment daytime average systolic, diastolic, and mean arterial blood pressure levels were significantly lower compared to values obtained during exacerbation of allergic rhinitis. Decrease in blood pressure with treatment of allergic rhinitis and nasal congestion suggests that nasal congestion and impaired nasal respiration may affect blood pressure and potentially cause serious problems in hypertensive patients with allergic rhinitis.

Value of neutrophil to lymphocyte and platelet to lymphocyte ratios in pneumonia.

PURPOSE: In our study, we aimed to evaluate neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with Community-acquired pneumonia (CAP). METHODS: This is a retrospective study consisting of 114 patients with CAP and 50 control subjects. Patients with CAP were divided into 2 groups, as inpatient and outpatient. RESULTS: The main findings of our study were that NLR, PLR and CRP levels were significantly higher in CAP than those in the control group. These biomarkers were also higher in inpatient group than outpatient group, but not statistically significant. CONCLUSION: To our knowledge, this is the first study which investigated the role of NLR and PLR as inflammatory biomarkers and the difference in inpatients and outpatients with CAP and their correlation with CRP values in children. However, larger prospective studies are needed to establish their utility as a predictor for the presence of CAP (Tab. 1, Fig. 2, Ref. 9).

Paternal-specific S-allele transmission in sweet cherry (Prunus avium L.): the potential for sexual selection.

Homomorphic self-incompatibility is a well-studied example of a physiological process that is thought to increase population diversity and reduce the expression of inbreeding depression. Whereas theoretical models predict the presence of a large number of S-haplotypes with equal frequencies at equilibrium, unequal allele frequencies have been repeatedly reported and attributed to sampling effects, population structure, demographic perturbation, sheltered deleterious mutations or selection pressure on linked genes. However, it is unclear to what extent unequal segregations are the results of gametophytic or sexual selection. Although these two forces are difficult to disentangle, testing S-alleles in the offspring of controlled crosses provides an opportunity to separate these two phenomena. In this work, segregation and transmission of S-alleles have been characterized in progenies of mixed donors and fully compatible pollinations under field conditions in Prunus avium. Seed set patterns and pollen performance have also been characterized. The results reveal paternal-specific distorted transmission of S-alleles in most of the crosses. Interestingly, S-allele segregation within any given paternal or maternal S-locus was random. Observations on pollen germination, pollen tube growth rate, pollen tube cohort size, seed set dynamics and transmission patterns strongly suggest post-pollination, prezygotic sexual selection, with male-male competition as the most likely mechanism. According to these results, post-pollination sexual selection takes precedence over frequency-dependent selection in explaining unequal S-haplotype frequencies.

Awareness of allergy patients about herbal remedies: a cross-sectional study of residents of Ankara, Turkey

Objective: The use of herbs in patients with allergic diseases is a special problem and still controversial. The objective of this questionnaire-based study was to determine the rate of herbal use in allergy clinic outpatients as well as to explore patient knowledge. Methods: Patients with respiratory and/or skin disease, either atopic or non-atopic were assigned to a prospective questionnaire study conducted in allergy clinic outpatients. Results: Three hundred and ninety-five patients enrolled in the study. The mean age was 33.50 ± 12.14 years. Participants generally had a high educational level (40.5% college and 39% university graduated). The rate of herbal use was 14.2%. All characteristics were similar within herbal user and non-user patients, except gender and age. The number of female patients who use herbal products was greater than for males (p=0.043). Herbal use was common in patients in their late thirties (p=0.024). Three main rationales for herbal use were revealed: (i) acting upon advice of someone (41.1%); (ii) the belief that “herbals are always more beneficial than chemicals” (37.5%); and (iii) the trust that “herbals are always safe” (21.4%). Most of the participants have “no idea” (41.5%) or are “not sure” (33.7%) about potential harmful effects of herbs to allergic people. Conclusion: People will continue to use herbals for one reason or another. Allergists and clinical immunologists need to become more knowledgeable about herbal therapies so that they can inform patients about either the benefits or possible harmful effects of herbs

Awareness of allergy patients about herbal remedies: a cross-sectional study of residents of Ankara, Turkey.

OBJECTIVE: The use of herbs in patients with allergic diseases is a special problem and still controversial. The objective of this questionnaire-based study was to determine the rate of herbal use in allergy clinic outpatients as well as to explore patient knowledge. METHODS: Patients with respiratory and/or skin disease, either atopic or non-atopic were assigned to a prospective questionnaire study conducted in allergy clinic outpatients. RESULTS: Three hundred and ninety-five patients enrolled in the study. The mean age was 33.50+/-12.14 years. Participants generally had a high educational level (40.5% college and 39% university graduated). The rate of herbal use was 14.2%. All characteristics were similar within herbal user and non-user patients, except gender and age. The number of female patients who use herbal products was greater than for males (p=0.043). Herbal use was common in patients in their late thirties (p=0.024). Three main rationales for herbal use were revealed: (i) acting upon advice of someone (41.1%); (ii) the belief that "herbals are always more beneficial than chemicals" (37.5%); and (iii) the trust that "herbals are always safe" (21.4%). Most of the participants have "no idea" (41.5%) or are "not sure" (33.7%) about potential harmful effects of herbs to allergic people. CONCLUSION: People will continue to use herbals for one reason or another. Allergists and clinical immunologists need to become more knowledgeable about herbal therapies so that they can inform patients about either the benefits or possible harmful effects of herbs.

The role of ace gene polymorphism in the development of angioedema secondary to angiotensin converting enzyme inhibitors and angiotensin II receptor blockers.

BACKGROUND: Angiotensin Converting Enzyme inhibitors (ACEi) may cause angioedema, with an incidence of 0.1 % to 1 %, which may be life-threatening. ACEi induce angioedema by increasing the levels of bradykinin. Angiotensin II receptor blockers (ATRB), have a pharmacological profile similar to ACEi. The polymorphism of the ACE gene is based on the presence or absence of a 287-bp element on intron 16 on chromosome 17. The plasma level of ACE is related to gene polymorphism. ACE level in genotype DD is double that in genotype II. OBJECTIVE: The aim of this study was to investigate whether the relationship between ACE gene polymorphism and ACEi induced angioedema is present or not. METHODS: ACE gene polymorphism was investigated in patients with angioedema due to the use of ACEi or ATRB (n:32, group 1), in patients receiving ACEi or ATRB without angioedema (n:46, group 2), and healthy controls (n:96, group 3). RESULTS: ID polymorphism was the most frequent genotype in all groups, without any significant difference among the groups (p:0.868). ACE gene polymorphism was not related with the drugs used (ACEi or ATRB), localisation of angioedema, and female sex, in group 1. CONCLUSION: Our results showed that ACE gene polymorphism has no effect on ACEi or ATRB induced angioedema.

The role of ace gene polymorphism in the development of angioedema secondary to angiotensin converting enzyme inhibitors and angiotensin II receptor blockers

Background: Angiotensin Converting Enzyme inhibitors (ACEi) may cause angioedema, with an incidence of 0.1 % to 1 %, which may be life-threatening. ACEi induce angioedema by increasing the levels of bradykinin. Angiotensin II receptor blockers (ATRB), have a pharmacological profile similar to ACEi. The polymorphism of the ACE gene is based on the presence or absence of a 287-bp element on intron 16 on chromosome 17. The plasma level of ACE is related to gene polymorphism. ACE level in genotype DD is double that in genotype II. Objective: The aim of this study was to investigate whether the relationship between ACE gene polymorphism and ACEi induced angioedema is present or not. Methods: ACE gene polymorphism was investigated in patients with angioedema due to the use of ACEi or ATRB (n:32, group 1), in patients receiving ACEi or ATRB without angioedema (n:46, group 2), and healthy controls (n:96, group 3). Results: ID polymorphism was the most frequent genotype in all groups, without any significant difference among the groups (p:0.868). ACE gene polymorphism was not related with the drugs used (ACEi or ATRB), localisation of angioedema, and female sex, in group 1. Conclusion: Our results showed that ACE gene polymorphism has no effect on ACEi or ATRB induced angioedema

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Is allergenic similarity predictable in respiratory allergies?

BACKGROUND: First degree relatives of patients with allergic diseases are at increased risk of having the disorder. However, it is not clear whether two such related patients with allergic diseases are sensitive to the same antigens or not. OBJECTIVE: The aim of this study to determine whether or not first degree relatives with respiratory allergies are more likely to be skin test positive to the same allergen extracts as unrelated patients. PATIENTS AND METHODS: Skin test results for 35 common aeroallergens were compared in 264 pairs of genetically related subjects and 264 pairs of age and sex matched, but unrelated, subjects. We calculate the percentages of the concordant and discordant results in each group. Results are compared by using chi2 test. RESULTS: For all related and unrelated groups combined, there were significant differences with mites (der. pteronyssinus, der. farinae) and some moulds (aspergillus mix and rhizopus nigricans) (p<0.05); When the groups were subdivided into parent-child pairs and same or different sibling pairs, and the same comparisons were made, a significant difference was only found in both sibling pairs (p<0.05), not in parent-child pairs (p>0.05). Since there was no both positivity with aspergillus mix and rhizopus nigricans in the two groups, these two allergens were excluded from the study. CONCLUSION: It is concluded that we could not say that if one or both of parents are atopic to any allergens, their child will be atopic to the same allergens. Besides, when a respiratory allergy occurs in siblings, only the one who has house dust mite allergy sensitivity can possess the similar antigen sensitivity.

Is allergenic similarity predictable in respiratory allergies?

Background: First degree relatives of patients with allergic diseases are at increased risk of having the disorder. However, it is not clear whether two such related patients with allergic diseases are sensitive to the same antigens or not. Objective: The aim of this study to determine whether or not first degree relatives with respiratory allergies are more likely to be skin test positive to the same allergen extracts as unrelated patients. Patients and Methods: Skin test results for 35 common aeroallergens were compared in 264 pairs of genetically related subjects and 264 pairs of age and sex matched, but unrelated, subjects. We calculate the percentages of the concordant and discordant results in each group. Results are compared by using x2 test. Results: For all related and unrelated groups combined, there were significant differences with mites (der. pteronyssinus, der. farinae) and some moulds (aspergillus mix and rhizopus nigricans) (p < 0.05); When the groups were subdivided into parent-child pairs and same or different sibling pairs, and the same comparisons were made, a significant difference was only found in both sibling pairs (p < 0.05), not in parent-child pairs (p > 0.05). Since there was no both positivity with aspergillus mix and rhizopus nigricans in the two groups, these two allergens were excluded from the study. Conclusion: It is concluded that we could not say that if one or both of parents are atopic to any allergens, their child will be atopic to the same allergens. Besides, when a respiratory allergy occurs in siblings, only the one who has house dust mite allergy sensitivity can possess the similar antigen sensitivity

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Serum leptin levels and lipid profiles in patients with allergic rhinitis and mild asthma.

BACKGROUND: Despite improved understanding of the pathophysiology of allergic rhinitis and asthma, the effect of serum leptin level is still controversial. Only a few studies have been performed to investigate the serum leptin levels in allergic rhinitis and asthma, and contradictory results have been observed. OBJECTIVE: We aimed to investigate the association between leptin, lipid profiles and allergic rhinitis and mild asthma, and to determine whether inhaled and/or intranasal steroids affect the leptin levels. PATIENTS AND METHODS: We studied 43 patients with allergic rhinitis (10 of with mild asthma) (mean age 29.81, range 18-45 yr) and 32 volunteers as a control group (mean age 30.53, range 20-45 yr). RESULTS: Serum leptin levels in patients were 8.49 +/- 10.76 microg/ml, and did not differ from volunteers 5.42 +/- 6.63 microg/ml. (p > 0.05). We found a direct link between increased body mass index (BMI) and serum leptin levels (p = 0.008). No association was seen between leptin and triglyceride, HDL-cholesterol, VLDL-cholesterol, eosinophil, total IgE (p > 0.05); except for total cholesterol and LDL-cholesterol (p < 0.05). Although, no correlation between allergic rhinitis and mild asthma and serum level of leptin was shown, these parameters and age correlations were stronger in female than in male (p = 0.39 for male and p = 0.011 for female), and also found direct link between increased BMI and sex and patients group (p = 0.008 for male and p = 0.0001 for female). We also determined that there was no effect of inhaled and/or intranasal steroids statistically on serum leptin levels. CONCLUSION: Our data demonstrate that the serum levels of leptin and lipid profiles on allergic rhinitis and mild asthma were not different than those in controls.

Not all ACE inhibitor related angioedema is always evident: a case which is misdiagnosed as panic attack and speech disorder.

Angiotensin-converting enzyme (ACE) inhibitors are the most common medications responsible for angioedema. Angioedema is a potentially life threatening conditions especially in geriatric age patients that they have take a several medications include ACE inhibitors and non steroidal anti inflammatory drugs. We present a case an ACE inhibitor induced angioedema that confused many clinical events.

Serum leptin levels and lipid profiles in patients with allergic rhinitis and mild asthma / Niveles de leptina sérica y perfiles lipidicos en pacientes con rinitis alérgica y asma leve

Background: Despite improved understanding of the pathophysiology of allergic rhinitis and asthma, the effect of serum leptin level is still controversial. Only a few studies have been performed to investigate the serum leptin levels in allergic rhinitis and asthma, and contradictory results have been observed. Objective: We aimed to investigate the association between leptin, lipid profiles and allergic rhinitis and mild asthma, and to determine whether inhaled and/or intranasal steroids affect the leptin levels. Patients and methods: We studied 43 patients with allergic rhinitis (10 of with mild asthma) (mean age 29.81, range 18-45 yr) and 32 volunteers as a control group (mean age 30.53, range 20-45 yr). Results: Serum leptin levels in patients were 8.49 ± 10.76 µg/ml, and did not differ from volunteers 5.42 ± 6.63 µg/ml. (p > 0.05). We found a direct link between increased body mass index (BMI) and serum leptin levels (p = 0.008). No association was seen between leptin and triglyceride, HDL-cholesterol, VLDL-cholesterol, eosinophil, total IgE (p > 0.05); except for total cholesterol and LDL-cholesterol (p < 0.05). Although, no correlation between allergic rhinitis and mild asthma and serum level of leptin was shown, these parameters and age correlations were stronger in female than in male (p = 0.39 for male and p = 0.011 for female), and also found direct link between increased BMI and sex and patients group (p = 0.008 for male and p = 0.0001 for female). We also determined that there was no effect of inhaled and/or intranasal steroids statistically on serum leptin levels. Conclusion: Our data demonstrate that the serum levels of leptin and lipid profiles

Antecedentes: A pesar de la mejor comprensión de la patofisiología de la rinitis alérgica y del asma, el efecto del nivel sérico de la leptina (hormona proteica 16-kDa) todavía es controvertido. Solamente unos pocos estudios se han llevado a cabo para investigar los niveles séricos de lectina en rinitis alérgica y asma, habiéndose observado resultados contradictorios. Objetivo: Investigar la asociación entre leptina, perfiles lípidos y rinitis alérgica y asma, así como determinar si los esteroides inhalados o intranasales afectan a los niveles de leptina. Pacientes y métodos: 43 pacientes con rinitis (10 de ellos con asma leve) (edad entre 18-45 años, media 29,81) y 32 voluntarios como grupo control (edad entre 20-45 años, media 30,65). Resultados: los niveles de leptina en los pacientes fue de 8,49±10,76 µg/ml, sin diferencia con los voluntarios: 5,42±6,63 µg/ml (p>0.05), Encontramos una relación directa entre el incremento del índice de masa corporal (IMC) y los niveles de leptina (p=0.008). No se observó ninguna asociación entre la leptina y triglicéridos, HDL-colesterol, VLDL-colesterol, eosinofilia o IgE total (p>0.05); excepto para el colesterol total y el LDL-colesterol (p>0.05). Aunque no se encontró correlación entre la rinitis alérgica y asma leve con los niveles de leptina, la correlación de estos parámetros y la edad fueron más marcados para las mujeres que para los hombres (p=0.39 en los varones y p=0.011 en las mujeres), encontrándose así una relación directa entre el incremento del IMC y el sexo en el grupo de pacientes (p=0.008 en varones y p=0.0001 en mujeres). También se comprobó que esto no fue efecto de los esteroides inhalados o intranasales. Conclusión: nuestros datos demuestran que los niveles séricos de leptina y el perfil lipídico en la rinitis alérgica y el asma leve no difiere del de los controles sanos

Not all ACE inhibitor related angioedema is always evident: a case which is misdiagnosed as panic attack and speech disorder / No siempre es evidente la relación de los inhibidores ACE con el angioedema: un caso que equivocadamente se diagnosticó de ataque de pánico y trastorno del habla

Angiotensin-converting enzyme (ACE) inhibitors are the most common medications responsible for angioedema. Angioedema is a potentially life threatening conditions especially in geriatric age patients that they have take a several medications include ACE inhibitors and non steroidal anti inflammatory drugs. We present a case an ACE inhibitor induced angioedema that confused many clinical events

Los inhibidores de la enzima conversora de angiotensina (ACE) son los medicamentos más comunes responsables del angioedema. El angioedema es una amenaza potencial de las condiciones de vida, especialmente en pacientes de edad geriátrica que tienen que tomar varios medicamentos incluidos los inhibidores ACE y antiinflamatorios no esteroides. Se presenta un caso de angioedema inducido por un inhibidor ACE que causó muchas confusiones clínicas